Puri Suman, Pooni Puneet, Mohan Bishav, Bindal Vidushi, Verma Sugam, Verma Sumati, Gupta Rajiv Kumar
Department of Obstetrics and Gynaecology, Dayanand Medical College and Hospital, Ludhiana, India.
Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, India.
Cardiol Res. 2013 Jun;4(3):126-128. doi: 10.4021/cr278w. Epub 2013 Jul 11.
Autoimmune AV block is usually seen in association with autoimmune antibodies in mother that cross the placenta and damage the AV node of fetus. A 24-year-old primigravida, diagnosed to have SLE, at 25 weeks period of gestation found to have fetal bradycardia. Her ANA was moderately positive, SS-A (Ro) antibodies and SS-B (La) antibodies were positive. Fetal ECHO showed no structural defect but heart rate was 55 - 60 beats per minute. She was put on dexamethasone (4 mg/day). She was lost on follow up and presented at term in emergency with labor pains and fetal bradycardia, underwent a lower segment caesarean section. Baby underwent a temporary cardiac pacing within 10 hours of birth followed by permanent pacing on day 3 of birth. Baby is doing well on follow up. Neonates with isolated congenital heart block who are monitored antenatally and delivered in a planned fashion at an institution capable of early pacing can have favorable outcomes.
自身免疫性房室传导阻滞通常与母体中的自身免疫抗体有关，这些抗体可穿过胎盘并损害胎儿的房室结。一名24岁的初产妇，在妊娠25周时被诊断为系统性红斑狼疮，发现胎儿心动过缓。她的抗核抗体呈中度阳性，抗SS-A（Ro）抗体和抗SS-B（La）抗体呈阳性。胎儿超声心动图显示无结构缺陷，但心率为每分钟55 - 60次。她接受了地塞米松治疗（4毫克/天）。她失访了，足月时因宫缩疼痛和胎儿心动过缓急诊就诊，接受了下段剖宫产。婴儿在出生后10小时内进行了临时心脏起搏，出生后第3天进行了永久起搏。随访时婴儿情况良好。对孤立性先天性心脏阻滞的新生儿进行产前监测，并在有能力早期起搏的机构进行计划性分娩，可取得良好的结果。
